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HomeMy WebLinkAboutRFP - 7562 THIRD PARTY CLAIMS ADMINISTRATOR SERVICESRFP 7562 Third Party Claims Administrator Services Page 1 of 30 REQUEST FOR PROPOSAL 7562 THIRD PARTY CLAIMS ADMINISTRATOR SERVICES The City of Fort Collins is requesting proposals from qualified professionals for a Third Party Claims Administrator to provide self-insured workers' compensation and liability claims services. Proposals submission via email is preferred. Proposals shall be submitted in Microsoft Word or PDF format and e-mailed to: purchasing@fcgov.com. If electing to submit hard copy proposals instead, five (5) copies, will be received at the City of Fort Collins' Purchasing Division, 215 North Mason St., 2nd floor, Fort Collins, Colorado 80524. Proposals will be received before 3:00 p.m. (our clock), October 29, 2013 and referenced as Proposal No. 7562. If delivered, they are to be sent to 215 North Mason Street, 2nd Floor, Fort Collins, Colorado 80524. If mailed, the address is P.O. Box 580, Fort Collins, 80522-0580. The City encourages all disadvantaged business enterprises to submit proposals in response to all requests for proposals and will not be discriminated against on the grounds of race, color, national origin for all proposals for negotiated agreements. Questions concerning the scope of the project should be directed to Project Manager, Lance Murray at (970) 221-6807 or lmurray@fcgov.com. Questions regarding bid submittal or process should be directed to Gerry S. Paul, Director of Purchasing Risk Management at (970) 221-6779 or gspaul@fcgov.com. All questions must be submitted in writing via email to Lance Murray, with a copy to Gerry Paul, no later than 5:00 PM (MST) on October 18, 2013. A copy of the Proposal may be obtained as follows: 1. Download the Proposal/Bid from the BuySpeed Webpage, www.fcgov.com/eprocurement The City of Fort Collins is subject to public information laws, which permit access to most records and documents. Proprietary information in your response must be clearly identified and will be protected to the extent legally permissible. Proposals may not be marked ‘Proprietary’ in their entirety. Information considered proprietary is limited to material treated as confidential in the normal conduct of business, trade secrets, discount information, and individual product or service pricing. Summary price information may not be designated as proprietary as such information may be carried Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707 fcgov.com/purchasing RFP 7562 Third Party Claims Administrator Services Page 2 of 30 forward into other public documents. All provisions of any contract resulting from this request for proposal will be public information. Sales Prohibited/Conflict of Interest: No officer, employee, or member of City Council, shall have a financial interest in the sale to the City of any real or personal property, equipment, material, supplies or services where such officer or employee exercises directly or indirectly any decision-making authority concerning such sale or any supervisory authority over the services to be rendered. This rule also applies to subcontracts with the City. Soliciting or accepting any gift, gratuity favor, entertainment, kickback or any items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is prohibited. Collusive or sham proposals: Any proposal deemed to be collusive or a sham proposal will be rejected and reported to authorities as such. Your authorized signature of this proposal assures that such proposal is genuine and is not a collusive or sham proposal. The City of Fort Collins reserves the right to reject any and all proposals and to waive any irregularities or informalities. Sincerely, Gerry S. Paul Director of Purchasing & Risk Management RFP 7562 Third Party Claims Administrator Services Page 3 of 30 TABLE OF CONTENTS SECTION I - REQUEST FOR PROPOSAL 4 1. PURPOSE AND BACKGROUND 4 2. SPECIFICATIONS 4 3. ANCILLARY SERVICES 4 4. CONTINUANCE OF SERVICE CONTRACT FOR A FIVE YEAR PERIOD 5 5. SELECTION CRITERIA AND METHOD 5 SECTION II - PROPOSAL REQUIREMENTS 7 1. QUALIFICATIONS 7 2. CLAIMS IMPLEMENTATION, PROCESSING AND TERMINATION 8 3. DATA PROCESSING AND REPORTING SERVICES 9 4. AVAILABILITY 10 5. PRICING AND FEES 11 SECTION III - CLAIMS MANAGEMENT STANDARDS & PROCEDURES 13 I. CLAIMS ADMINISTRATION 13 2. CLAIMS INVESTIGATION AND MANAGEMENT 14 3. CLAIMS ANALYSIS AND REPORT 15 4. SPECIAL SERVICES 15 SECTION IV - CLAIMS PHILOSOPHY 16 SECTION V - SPECIAL PROVISIONS 17 SECTION VI - APPENDIX DATA 18 Exhibit I 19 SECTION VII – SAMPLE SERVICES AGREEMENT 20 RFP 7562 Third Party Claims Administrator Services Page 4 of 30 SECTION I - REQUEST FOR PROPOSAL The City of Fort Collins invites your firm to submit a proposal for Third Party Claims Administrator to provide self-insured workers' compensation, property and liability claims services. 1. PURPOSE AND BACKGROUND The City's purpose of this RFP is to select a qualified claims administrator to handle workers' compensation, property and liability claims. Evaluations of submittals to this RFP will be evaluated by City personnel with potential input from an independent third-party consultant. When evaluations are complete, top scoring vendors may be called upon to present their services to the team of evaluators for further consideration. Upon completion of scoring and evaluation, a Claims Administrator contract will be awarded. The Claims Administrator may administer workers' compensation, property and liability, or depending on excess markets, may administer a combination of coverage lines. The City's property, liability and worker’s compensation claims have been administered by Cannon Cochran Management Services, Inc. since 01-01-99. Due to the need to maintain a close working relationship, and timely responses in the event of an incident requiring immediate assistance, the Claim Administrator may be required to have a servicing office in Fort Collins. 2. SPECIFICATIONS Proposals are to be submitted in strict compliance with these specifications. These specifications are to be considered as providing desirable claims administration services. Any limitations or deviations from these specifications must be designated in the proposal; otherwise, companies proposing will be strictly held to the specifications. This Request for Proposals and your response will become an integral part of a final contract should your firm be selected. A failure to deliver services and fees quoted in your proposal may result in a mid- term cancellation of the Service Contract and a replacement of the Third Party Administration firm. The information contained in the specifications is believed to be correct, but is not warranted. The responsibility for determining the full extent of the exposure and the verification of all information shall rest solely upon the Third Party Administrator. The City of Fort Collins or its representatives, will not be responsible for any errors or omissions, nor for the failure on the part of the Third Party Administrator to determine the full extent of the exposures. 3. ANCILLARY SERVICES All Proposals must fully describe the nature of any ancillary services which your firm may offer. If independent firms are to be used, the name and address of the firms are to be shown. RFP 7562 Third Party Claims Administrator Services Page 5 of 30 4. CONTINUANCE OF SERVICE CONTRACT FOR A FIVE YEAR PERIOD It is the intent of the City to continue the service contract for a minimum period of five years without competitive quotations. However, the City reserves the right to cancel or non-renew the contract at its discretion. 5. SELECTION CRITERIA AND METHOD A Review Team will rank the proposals based on the City of Fort Collins' procedures for the review of professional firms. The three highest ranked firms may then be invited to discuss their proposals and qualifications with the review team. Based on these interviews, a final ranking of the consultants will be made and contract negotiations will be initiated with the highest ranked firm. On-site tours may be requested. THE FOLLOWING POINT SYSTEM WILL BE USED: POINTS QUALIFICATION STANDARD 1 - 5 Adequacy of current Proposal in light of the Proposal requirements Meeting and understanding needs; administrative procedures 1 - 15 Qualifications to perform services References, management and staff assigned 1 - 15 Computer support and reports Data base availability reports initiated 1 - 5 Availability Ability to be at an Incident scene within one hour 1 - 10 Reasonable cost for proposed service Services provided Total Points (50 points possible) RFP 7562 Third Party Claims Administrator Services Page 6 of 30 Reference Evaluation (Top Ranked Firm) The project manager will check references using the following criteria. The evaluation rankings will be labeled Satisfactory/Unsatisfactory. QUALIFICATION STANDARD Overall Performance Would you hire this Professional again? Did they demonstrate the skills & knowledge required by this project? Timetable Was the original Scope of Work completed within the specified time? Were interim deadlines met in a timely manner? Completeness Was the Professional responsive to client needs? Did the Professional anticipate problems? Were problems solved quickly and effectively? Budget Was the original Scope of Work completed within the project budget? Job Knowledge a) If a study, did it meet the Scope of Work? b) If Professional administered a construction contract, was the project functional upon completion and did it operate properly? Were problems corrected quickly and effectively? RFP 7562 Third Party Claims Administrator Services Page 7 of 30 SECTION II - PROPOSAL REQUIREMENTS Please address the following questions, in the order they are asked, in your proposal. 1. QUALIFICATIONS A. Give a brief description of your firm including: 1. Names of principal owners, partners or officers. 2. Length of time the firm has been in business. 3. Number of offices and locations. 4. Offices that would service this account. 5. The availability of a toll-free number and/or e-mail address for the use of claimants, and the City. B. Indicate the proposed number of personnel (including supervisory and management) who would be assigned to administer the City's program and give details regarding: 1. Position of each 2. Experience and education 3. Experience with public entities 4. Length of time with your firm 5. Computer skills C. Would technical personnel be assigned to the City? If so, how many? D. Would an Account Executive be assigned as the primary contact on items not directly related to specific claims? E. Describe training programs offered to claim personnel and incentives for employees to further their training and education. F. In the past two years, what percentage of employee turnover has your firm experienced for the office that will be handling the City’s claims? G. What is the anticipated case load of open files that would be managed by examiners assigned to this account? H. Provide names, addresses, telephone numbers and length of service with at least three Colorado references for which you have provided worker's compensation, property and liability claims services (preferably public agencies). I. Describe any additional special programs or areas of emphasis that you think would be beneficial in helping us to understand your level of expertise. RFP 7562 Third Party Claims Administrator Services Page 8 of 30 2. CLAIMS IMPLEMENTATION, PROCESSING AND TERMINATION A. Provide procedure and timetable for initial set-up and implementation of City's account into your system. B. Provide the set-up, process and timetable for a new claim to be placed in the system. C. Advise how frequently your diary system allows claims supervisory personnel to review open claims. D. Describe your procedures for making initial and follow-up contact with injured employees or claimants. E. Describe your company philosophy and procedures for the establishment of case reserves. What are the procedures for revising reserves? F. Describe cost containment procedures utilized by your firm. G. Describe how medical bill review services take place within your firm or contractor and provide a cost benefit analysis of its potential effect on the City. H. Under the current arrangement, the City provides an account and checks for the processing of claim payments by the claim administrator. Indicate if this system would work for your firm. I. Advise in what instances an independent adjustor would be required and which independent claims service you would use. J. Attach copies of all standard forms used in your administration process. K. Submit samples of any cards, letters, pamphlets, etc. that would be provided to injured employees and claimants. L. Do you have a formal program for managing lawsuits and litigation expense? If so, please describe. M. Provide the City with various options regarding the handling of open claims in the event of termination or regular expiration of the claims administrator contract. N. Include any other information that you feel would contribute a positive and successful program if your firm were selected. Describe in detail the claims administrator's various investigative techniques and general claim handling philosophies, addressing the following: 1. Method of explaining claimant's right. 2. Circumstances when in-person investigations would be used rather than by telephone. 3. Philosophy and method of contesting and denying claims payments. O. Provide a description of the quality controls currently in place. The description should include the approach to and frequency of internal claims audits of claims offices. RFP 7562 Third Party Claims Administrator Services Page 9 of 30 3. DATA PROCESSING AND REPORTING SERVICES A. To demonstrate your data processing and report system, provide an online demonstration of twenty five worker’s compensation claims. Five claims shall be re-opened from the year 2011, ten claims shall be medical only, and ten shall be indemnity claims. Be as detailed as possible, showing all charges, fee schedule, PPO & prescription discounts, and the bottom line cost to the city for each claim. All claims shall contain, but not be limited to, the following information. 1. Workers' Compensation a. Claim Number b. Department Name c. Employee Name d. Injury Date, Day of Week and Time of Day e. Brief Description of Injury/Accident f. Nature of Injury g. Body Part h. Nature of Incident i. Object Causing Injury j. Medical, Indemnity and Expense Paid to Date k. Subrogation l. Rehabilitation m. Reserved n. Litigation o. Status 2. Liability a. Line of Coverage b. Department Name c. Claim Number d. Incident Date, Day of Week and Time of Day e. Claimant's Name f. Brief Verbal Description of Incident g. Nature of Incident h. Object causing Incident RFP 7562 Third Party Claims Administrator Services Page 10 of 30 I. Payment and Expense Paid to Date j. Reserve k. Indication if in Suite l. Status (Open/Closed) B. Indicate whether the following reports could be provided online: 1. Incident analysis report giving a breakdown by cause, body part, injury, day, time, etc. 2. Vendor report to identify service providers and attorney involvement. 3. Cumulative check register giving a summary of all medical, indemnity and other payments to date. 4. Reports showing IBNR factors and trending, claims pay-out profiles and claims development analysis. 5. Sorting capabilities of program. 6. OSHA 300 Log 7. Recordable Accident Frequency Rate (RAF) 8. Days Away, Restricted or Transferred (DART) C. Can your organization customize reports for our needs? Is there an extra charge for this service? D. Can reports be exported to an MS Excel, Access or PDF format? E. Can your organization interface with the J. D. Edwards One World Workforce Management System? F. Does your organization have the capability to captures all correspondence, medical records, letters, etc., electronically and store them in the claimants file? G. Is it possible for authorized City personnel to access your data base? If so, please describe your system, the necessary mechanics, and what information would be available to access. H. Advise how frequently your system is updated. I. Please submit samples of each standard report generated by your system and explain any additional ad hoc reporting capability you could put at our disposal. J. Describe how your firm ensures the confidentiality of client data. 4. AVAILABILITY A. Approximately how far is the servicing office from downtown Fort Collins? Is an operational office in Fort Collins at contract inception an option for one, or all lines of claims? RFP 7562 Third Party Claims Administrator Services Page 11 of 30 B. Can your firm respond immediately to investigate an incident that has just occurred? Indicate how long it would take a claim representative to physically be on-site of an incident after telephone notification. C. Are your claim representatives "on call" 24 hours per day? Are pagers, cell phones or similar devices provided to the representatives? D. How many representatives could reasonably be expected to handle claims for the City? E. What is the claims ratio between an adjuster and the number of claims handled? 5. PRICING AND FEES If different pricing and fees are used for workers' compensation and liability, please quote separately. A. Quote you’re per claim fee in one or more of these ways: 1. Cost per claim (regardless of type). 2. Cost per claim by type. 3. Minimum cost/maximum costs. 4. Lifetime handling of claims. If a flat fee is submitted, please include the total number of claims included in the fee and the annual maximum cost. Other pricing methods will also be considered. Indicate if a different fee could be charged to track "record only" claims. The City currently pays a guaranteed one-time fee for a specified number of claims per year for lifetime management of those claims. The third party administrator handles these claims until all are closed. An additional fee per claim is paid if the number of claims handled by the T.P.A. exceeds the number of claim specified in the contract. Simple claims that require no investigation (a check or denial letter is issued) are handled at a predetermined cost per claim. B. Specify whether or not your fee includes your firm performing all of the necessary state filing. C. Indicate whether the per claim cost includes recovery of subrogation losses. D. Indicate the types of allocated claims expenses which are not included in your per case claims costs. E. State what services or type of claims that are not included in your standard fees. F. WorkWell and University of Colorado Health are the designated health care provides. Are they part of your organizations PPO network and if so what discount do you receive? What other Northern Colorado health care providers are part of your PPO network? RFP 7562 Third Party Claims Administrator Services Page 12 of 30 G. Explain your prescription drug program and bill review processes. H. Since the term of the contract will be five years, renewable annually, give an indication of expected rate changes, basis for changes, and how your firm intends to control cost. RFP 7562 Third Party Claims Administrator Services Page 13 of 30 SECTION III - CLAIMS MANAGEMENT STANDARDS & PROCEDURES Following are standards and services the City wishes to maintain. Review these points and indicate any area that could be a problem in your firm. I. CLAIMS ADMINISTRATION A. Create files and reserve within two (2) working days from receipt of the initial report. B. Establish diaries so each claim is reviewed at least every thirty (30) days or more frequently where needed. Document confirmation of review. C. Working with City of Fort Collins Risk Management staff, regularly examine and analyze all claims to determine compensability/validity of workers’ compensation and liability claims. D. Pay bills promptly per City instructions. E. Audit medical bills and repair bills for causal relationship and reasonableness of charges. F. Report all indemnity claims to the Index Bureau upon file creation, and retain a copy with the file. G. Review medical-only claims for possible closure no less frequently than every thirty (30) days. H. Provide copies of all written correspondence from the administrator to doctors, claimants, attorneys, rehabilitation counselors, investigators and state agencies. I. Clearly document all file activity, including telephone conversations or personal meetings, and diary reviews to reflect the date, individuals involved, content of discussion and plan of action electronically and provide authorized City employee access. J. Establish specific direction on the investigation and handling of all indemnity cases within three (3) working days from receipt of the initial report, and clearly evidenced in the file. K. Notify appropriate excess insurer(s) of all claims or losses meeting the reporting requirements of the insurer and provide such insurer with all required information and updates. Send update reports to excess carriers no less frequently than semi-annually or as directed by the City. L. Provide a written analysis or report of all proposed settlements by stipulation or compromise for consideration and authorization, in losses valued in excess of $50,000. M. Establish claim reserves and provide a continual review and update of reserves to reflect changes. It is expected that reserves will be reviewed at least quarterly with staff. RFP 7562 Third Party Claims Administrator Services Page 14 of 30 N. Maintain a file for each claim submitted with the file available for review by the City at any reasonable time. O. Consult and cooperate with employees as may be necessary to achieve a successful claims management program. This includes regular communications between City staff and the Third Party Administrator to discuss claim progress settlements and denials. P. Consult quarterly with City Risk Management and Legal staff to review open claims and reserve settings. 2. CLAIMS INVESTIGATION AND MANAGEMENT A. Conduct the necessary investigation of each claim using competent and qualified personnel, including such investigation as is necessary to determine liability. The City reserves the right to require additional investigation. With the approval of the City, engage the services of persons of firms outside its organization for special work in connection with investigations. B. Contact or attempt to contact all employees and claimants within three (3) days of receipt of claim. Upon initial contact, document the description of injury/accident. Document attempts to contact employee or claimant. C. Contact the department and designated employee for City's statement before determining liability. D. Contact the City within three (3) days to confirm whether compensability/liability is acknowledged or should have been questioned. E. Monitor treatment program for injured employees to assure that treatment is related to the compensable injury or illness. F. Consult with City Risk Management staff prior to authorizing medical procedures. G. Maintain a close liaison with treating physicians to assure that employees receive proper care and to avoid over treatment situations. H. Determine eligibility for and authorize payment of Temporary Disability compensation in accordance with medical advice, rehabilitation efforts and State law. I. With City approval, maintain telephone or personal contact with temporarily disabled employees no less frequently than monthly, to maintain rapport and to monitor medical progress and return to work status. J. Schedule independent medical examinations with qualified physicians in cases where treatment, length of disability or extent of permanent disability assigned is in question. RFP 7562 Third Party Claims Administrator Services Page 15 of 30 K. Investigate whether subrogation can be ruled out or pursued in all cases which may involve third party negligence. L. Refer litigated cases to attorneys utilizing an agreed listing of legal firms. Assist in the preparation of litigated cases and participate as needed in hearings and settlement actions. M. Attend monthly meetings with City designated physician. 3. CLAIMS ANALYSIS AND REPORT A. Provide the City with continuing information on the progress of individual claims and the effectiveness of cost control programs relating to all claims. A closing report is required for every claim indicating the amount paid to settle the claim. B. Submit statistical summaries and narrative reports as requested to assist in the evaluation of the City programs. C. Assist the City in the analysis of claims in an effort to prevent future occurrences of a similar nature. D. Maintain a claim file for each reported claim which shall be available to the City at all times for inspection. Such file shall contain all data pertinent to the claim to support its disposition and shall remain the exclusive property of the City. E. Assist the City in preparation of required self-insurance reports, reports required by the city’s insurance carriers, and information for the NCCI to calculate the workers’ compensation modifier. 4. SPECIAL SERVICES A. Provide information and guidance to City employees regarding workers' compensation benefits and respond to inquiries regarding specific injuries and permanent disability ratings. B. When appropriate, develop rehabilitation programs for injured employees for approval by the City, the employee and appropriate agencies ensuring that rehabilitation, retraining or reassignment is provided to employees with physical or performance limitations resulting from industrial injuries. C. Review existing City claims management programs and procedures and recommend changes as needed. RFP 7562 Third Party Claims Administrator Services Page 16 of 30 SECTION IV - CLAIMS PHILOSOPHY The City of Fort Collins' claims management philosophy is as follows: 1. Claimants are given a high standard of care and concern. 2. Employees are clearly advised of their benefits under Workers' Compensation in a timely fashion. 3. To give prompt attention to all claims matters and to discourage unnecessary litigation. 4. To encourage early recovery from injury and early return to productive work. 5. To encourage employees' return to work for modified duty. 6. To identify fraudulent claims and aggressively defend those claims. 7. To identify cause of loss and correct, if necessary, to prevent future loss. 8. To keep communication open between the TPA, Risk Management staff, employees, claimants, and medical providers. RFP 7562 Third Party Claims Administrator Services Page 17 of 30 SECTION V - SPECIAL PROVISIONS 1. CLAIM ASSIGNMENT The City of Fort Collins does not send all claims to a third party claims administrator. The City Attorney’s Office and the Risk Management division reserve the right to determine which claims will be handled in-house and those that will be assigned to the third party administrator. 2. CANCELLATION BY ADMINISTRATOR Because of the time required to replace this contract on a favorable basis, each firm must include in their proposal a written agreement not to change the rates and terms of the contract, nor cancel the contract during the first annual term. Each firm must also agree not to change the rates and terms of the contract at renewal or refuse to renew the contract without ninety (90) days advance written notice. 3. CLAIMS RUN-OFF PROVISIONS Ensure that your company's claims run-off requirements, including fees for present as well as future claims, are included with a proposed contract provision. 4. TITLE RIGHTS Ensure that the City shall have full, complete and absolute title to all studies, files, documents, correspondence, tapes, movies, recordings, reports, analyses and other materials prepared or acquired regardless of the state of completion. Further ensure that the City may make full and complete use of said materials as it desires, and within its own discretion without liability of any kind whatsoever to the Administrator other than payment of consideration as provided. 5. INSURANCE Required insurance limits are listed in Exhibit B, Section VII, Sample Service Services Agreement. RFP 7562 Third Party Claims Administrator Services Page 18 of 30 SECTION VI - APPENDIX DATA EXHIBIT I Five Year Claim History RFP 7562 Third Party Claims Administrator Services Page 19 of 30 EXHIBIT I Five Year Claim History 1. Workers’ Compensation Year # Claims # Med Only # Indemnity # Open Incurred Cost 2008 179 145 34 1 $649,415 2009 153 121 32 1 $799,684 2010 159 131 28 0 $629,225 2011 179 131 49 3 $1,171,140 2012 158 130 28 5 $490,290 2. Auto Liability Year # Claims # Open Incurred Cost 2008 45 0 $ 93,259 2009 51 0 $ 54,539 2010 48 0 $161,961 2011 43 1 $186,042 2012 31 0 $ 28,055 3. General Liability Year # Claims # Open Incurred Cost 2008 102 0 $191,637 2009 102 0 $174,120 2010 105 0 $702,424 2011 102 2 $232,511 2012 87 3 $140,171 Of the auto liability and general liability claims listed, the City of Fort Collins handles approximately 100 of these claims in-house per year. The TPA has to either issue a check for payment or a denial letter on these files. All claims data is as of 9/24/13. RFP 7562 Third Party Claims Administrator Services Page 20 of 30 SECTION VII – SAMPLE SERVICES AGREEMENT SERVICES AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and , hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of ( ) page and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Professional shall be solely responsible for performance of all duties hereunder. 2. The Work Schedule. [Optional] The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule attached hereto as Exhibit "B", consisting of ( ) page , and incorporated herein by this reference. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within ( ) days following execution of this Agreement. Services shall be completed no later than . Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 4. Contract Period. [Option 1] This Agreement shall commence upon the date of execution shown on the signature page of this Agreement and shall continue in full force and effect RFP 7562 Third Party Claims Administrator Services Page 21 of 30 for one (1) year, unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for an additional period of one (1) year at the rates provided with written notice to the Professional mailed no later than ninety (90) days prior to contract end. 5. Contract Period. [Option 2] This Agreement shall commence , 200 , and shall continue in full force and effect until , 200 , unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed ( ) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. The Denver Boulder Greeley CPIU published by the Colorado State Planning and Budget Office will be used as a guide. Written notice of renewal shall be provided to the Service Provider and mailed no later than ninety (90) days prior to contract end. 6. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City of such condition within fifteen (15) days from the onset of such condition. 7. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Service Provider: City: Copy to: RFP 7562 Third Party Claims Administrator Services Page 22 of 30 Attn: City of Fort Collins Attn: PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of early termination by the City, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement. Such payment shall be the Service Provider's sole right and remedy for such termination. 8. Contract Sum. The City shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, ($ ) as per the attached Exhibit " ", consisting of page , and incorporated herein by this reference. 9. City Representative. The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City Representative. 10. Independent Service provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 11. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its RFP 7562 Third Party Claims Administrator Services Page 23 of 30 respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City, nor will it obligate the City to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City to the same extent as the work of the Service Provider. 12. Personal Services. It is understood that the City enters into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City. 13. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement. 14. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. RFP 7562 Third Party Claims Administrator Services Page 24 of 30 c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City-furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City. 15. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof. 16. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 17. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 18. Indemnity/Insurance. RFP 7562 Third Party Claims Administrator Services Page 25 of 30 a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit , consisting of one (1) page, attached hereto and incorporated herein by this reference. The Service Provider before commencing services hereunder, shall deliver to the City's Director of Purchasing and Risk Management, P. O. Box 580 Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 19. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 20. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 21. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. RFP 7562 Third Party Claims Administrator Services Page 26 of 30 seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and RFP 7562 Third Party Claims Administrator Services Page 27 of 30 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 22. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit " " - Confidentiality, consisting of ( ) pages, attached hereto and incorporated herein by this reference. RFP 7562 Third Party Claims Administrator Services Page 28 of 30 CITY OF FORT COLLINS, COLORADO a municipal corporation By:_______________________________ Gerry Paul Director of Purchasing and Risk Management Date:_____________________________ ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: ________________________________ Assistant City Attorney By:_______________________________ __________________________________ PRINT NAME __________________________________ CORPORATE PRESIDENT OR VICE PRESIDENT Date:_____________________________ ATTEST: ( Corporate Seal) _____________________________ CORPORATE SECRETARY RFP 7562 Third Party Claims Administrator Services Page 29 of 30 EXHIBIT INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: " The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins." In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. The City, its officers, agents and employees shall be named as additional insured’s on the Service Provider's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement: 1. Workers' Compensation insurance with statutory limits as required by Colorado law. 2. Employer's Liability insurance with limits of $500,000 per accident, $1,000,000 disease aggregate, and $500,000 disease each employee. B. Commercial General & Vehicle Liability. The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. RFP 7562 Third Party Claims Administrator Services Page 30 of 30 EXHIBIT CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City, or the City so requests for any reason, the Service Provider shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law.